Critical Care Medicine Fellowship

Overview

The Critical Care Medicine Fellowship Program at the University of Maryland is designed to prepare both Internal Medicine- and Emergency Medicine-trained physicians in all aspects of medical, surgical, trauma and neurologic critical care. The fellowship's comprehensive two-year curriculum integrates the multiple and complex facets of caring for the critically ill in a wide variety of environments to guarantee that fellows receive the best training possible. The fellowship expects to have 4 fellows per class.

While the fellowship is based in the Medical Intensive Care Unit and the Department of Medicine, fellows also spend substantial time in other Intensive Care Units (ICUs). During a two-year fellowship, fellows can expect to spend 4-5 months in the medical ICU at the University of Maryland Hospital, 3-4 months in the trauma ICUs at the world-renowned R Adams Cowley Shock Trauma Center, 2-3 months in (non-trauma) surgical units, 2 months in the Neuro ICU, and 2 months in a UMMC-affiliated community ICU. One introductory didactic month and a combined 6-7 months of research and electives round out the program. Our menu of electives is diverse and flexible and includes options as varied as: pulmonary hypertension, pulmonary consults, critical care infectious disease, trauma anesthesia, ultrasound, international, and burns. As a result of this clinically “heavy” and balanced program, our fellows have the opportunity to both graduate as archetypical “multi-disciplinary” intensivists and simultaneously develop expertise within their own personal areas of interest.

Didactic Training

The University of Maryland has partnered with Washington Hospital Center, Georgetown University, the National Institutes of Health, and the Walter Reed National Medical Center to provide a unique training course in the fundamentals of critical care during the first three weeks of the fellowship. Fellows participate in both lectures (e.g. respiratory physiology, post-surgical ICU management, renal replacement therapy) and simulated training sessions (e.g. ventilator management, intubation, tube thoracostomy) to prepare them for their clinical rotations.

The Division has comprehensive weekly didactic conferences which fellows are required to attend when on Medicine-based rotations:

Pulmonary and Critical Care Medicine Grand Rounds, during which relevant clinical and basic science topics are presented with an evidence based approach.

Critical Care Core Curriculum Conference, which provides fellows with the foundation of critical care knowledge they are expected to know; Journal Club is incorporated into this.

Interdisciplinary Chest Conference, in which a fellow presents a clinical case along with a discussion of the relevant radiologic and pathologic materials, as well as a literature review of the highlighted illness.

Other conferences include a monthly Interdisciplinary Critical Care Conference, which is a combined critical care conference with medical, surgical, and pediatric critical care specialists. In addition, when fellows rotate in the surgery-based ICUs, they will participate in the weekly surgical critical care didactic conferences. Finally, as a major academic medical center, many other departmental conferences and lectures exist that fellows are encouraged to attend as their schedules allow.

Clinical Training

The clinical training program at UMMC occurs in a diverse set of busy and nationally-recognized units. For example:

The University of Maryland Medical Center is regularly ranked among the top 50 hospitals in the U.S. by the Leapfrog Group and other hospital rating organizations.

R Adams Cowley Shock Trauma Center -- one of only a handful of freestanding trauma hospitals in existence--is the world's busiest civilian trauma center and a world thought-leader in the care of trauma and surgical critical care.

In addition to being a pioneer in the development of cardiac assist devices, our very busy Cardiac Surgery ICU is the hub of one of the country's busiest ECMO programs.

The University of Maryland Transplant Surgery Program is recognized as one of the largest and most successful transplant centers in the United States. Fellows will receive extensive exposure to the pre- and post-transplant management of both thoracic and abdominal organ transplant patients across several clinical services.

With our new critical care tower nearing completion, UMMC is adding 64 new and replacement ICU beds as well as expanding the emergency department and the simulation center.

Research

Fellows are expected to complete a publishable scholarly project prior to graduation. This may include primary research, a book chapter or review article. Extensive benchtop and clinical research opportunities and technical support are available within the department and the wider institution. Mentorship as well as funding support from F-series, K-series, and other grants are available for those preparing for a research-oriented career track.

Work Environment

One of the best aspects of our program is that we genuinely like our co-workers. The faculty are friendly, supportive, and generally quite flexible and receptive to the needs of the fellows. The clinical work schedule, while busy, is not oppressive. The fellows collectively enjoy being together and socialize regularly, with faculty members commonly joining in.

Overall Program Strengths & Goals

The overall goal of our fellowship program is to provide comprehensive clinical training and a broad range of research opportunities in order to create a strong foundation for a successful career in Critical Care Medicine. The division chief and fellowship program director are committed to achieving these goals. Both meet with each fellow regularly to discuss their current fellowship training experience and their career plans for the future. For fellows pursuing a career in clinical practice, this fellowship provides immense clinical experience along with exposure to clinical or basic science research. For fellows choosing a career in academic medicine, this training will provide an excellent springboard for transition to the next step in their academic career development.